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New System Helps Reduce Errors at Shift Changes

Improved communication among health-care providers during shift changes reduced injuries due to medical errors by 30 percent, according to a federally funded, multicenter study involving St. Louis Children’s Hospital and eight other academic medical centers in the U.S. and Canada.

Tracking a group of pediatric residents, the research found that an intensive three-hour training program focused on improving oral and written communications greatly increased patient safety without significantly burdening existing workflow. The training program included role playing, computer training and use of a mnemonic to structure shift change communication and electronic health record information.

The program is called I-PASS, and the mnemonic is intended to help health-care personnel recall steps for properly communicating important patient information during a shift change. I-PASS stands for illness severity, patient summary, action list, situational awareness and contingency planning, and synthesis by receiver.
The study was led by researchers from Boston Children’s Hospital and Harvard Medical School and included physicians at Washington University School of Medicine. Their findings were reported Nov. 6 in The New England Journal of Medicine.

“This study suggests that a standardized process along with education and information technology support can reduce medical errors. These findings across nine different academic pediatric programs suggest they are generalizable,” said study co-author F. Sessions Cole, MD, (SLMMS), vice chair of the Department of Pediatrics at Washington University and chief medical officer of St. Louis Children’s Hospital.

Learn more about I-PASS and obtain curriculum materials at no cost

Read the full news release from Washington University

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